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- Title
Oblique lumbar interbody fusion for adjacent segment disease after posterior lumbar fusion: a case-controlled study.
- Authors
Jin, Cong; Xie, Minghua; He, Lei; Xu, Wenbin; Han, Weiqi; Liang, Wengqing; Qian, Yu
- Abstract
Background: This study assessed clinical and radiographic outcomes of oblique lumbar interbody fusion (OLIF) in comparison with posterior reoperation for adjacent segment disease (ASD). Methods: A total of 26 patients with symptomatic ASD after lumbar fusion were included in this retrospective case-controlled study conducted from January 2013 to December 2018. Twelve patients underwent single-segment OLIF with or without posterior instrumentation (OLIF group), whereas 14 patients underwent posterior reoperation (posterior approach group). The clinical outcomes included operative time, blood loss, hospital stay, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and complications. Preoperative and postoperative radiographic outcomes were compared. Results: The operative time (60.6 ± 16.1 min vs. 150.9 ± 28.5 min, respectively; P < 0.05) and the blood loss in the OLIF group 89.2 ± 49.0 ml vs. 340.7 ± 130.2 ml, respectively; P < 0.05) were significantly lower than those in the posterior group. The hospital stay was lower in the OLIF group than in the posterior approach group (6.6 ± 1.3 days vs. 9.5 ± 2.5 days, respectively; P < 0.05). In the posterior approach group, 6 of 14 patients (42.8%) had issue with dural tear, while none in the OLIF group had such issue (P < 0.05). The ODI score (13.2 ± 4.2 vs. 19.2 ± 7.2, respectively; P = 0.014) and the VAS back pain score were lower in the OLIF group postoperatively and at last follow-up. In the OLIF group, the radiographic outcomes were significantly improved postoperatively. Conclusions: Due to our results and early experiences, we proposed that OLIF was safe and effective for ASD. Compared with posterior reoperation, OLIF results in shorter operative time and hospital stay, lesser blood loss, and lower risk of dural injury.
- Subjects
LUMBAR vertebrae surgery; RISK of backache; SURGICAL complication risk factors; SURGICAL blood loss; PREOPERATIVE risk factors; FUNCTIONAL assessment; LENGTH of stay in hospitals; PATIENT aftercare; SPINE diseases; REOPERATION; SPINAL fusion; SPINAL injuries; PAIN measurement; VISUAL analog scale; TREATMENT effectiveness; RETROSPECTIVE studies; CASE-control method; PREOPERATIVE period; TREATMENT duration; DISEASE risk factors
- Publication
Journal of Orthopaedic Surgery & Research, 2019, Vol 14, Issue 1, pN.PAG
- ISSN
1749-799X
- Publication type
Article
- DOI
10.1186/s13018-019-1276-9